Mediastinal epithelioid hemangioendothelioma with abundant spindle cells and osteoclast-like giant cells mimicking malignant fibrous histiocytoma
1 Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang 110001, China
2 Department of Pathology, the First Affiliated Hospital and College of Basic Medical Science, China Medical University, Shenyang 110001, China
3 Institute of pathology and pathophysiology, China Medical University, Shenyang 110001, China
Diagnostic Pathology 2013, 8:103 doi:10.1186/1746-1596-8-103Published: 21 June 2013
Epithelioid hemangioendothelioma is a relatively uncommon lesion usually presenting in soft tissues. The occurrence in the mediastinum is exceptional rare. Histologically, this tumor is characterized by epithelioid cells with intracytoplasmic vacuoles in a hyalinized or mucinous stroma. Occasionally, spindle cells or osteoclast-like giant cells can be observed. Herein, we present a case of epithelioid hemangioendothelioma in a 38 year-old Chinese male. The tumor was predominantly composed of abundant spindle cells with marked atypia and scattered osteoclast-like giant cells reminiscent of malignant fibrous histiocytoma. The unusual histological appearance can pose a great diagnostic challenge. It may be easily misdiagnosed, especially if the specimen is limited or from fine-needle aspiration.